Purpose Statement
Post-Completion Attachment Management allows authorized users to add, update, view, and remove attachments from a completed (locked) ePCR without reopening the incident. This streamlines billing and administrative workflows while preserving the integrity of completed clinical documentation.
By separating attachment management from clinical record editing, agencies can continue to upload supplemental documentation—such as hospital face sheets or billing documents—without risking unintended modifications to patient care information.
Background Information
Many agencies receive supporting documentation after an ePCR has already been completed. Prior to this enhancement, users had to:
- Revert the incident to In Progress
- Upload the attachment
- Complete the incident again
This process created unnecessary work, delayed billing, and increased the possibility of accidental changes to completed patient care documentation.
With Post-Completion Attachment Management, authorized users can update attachments while the incident remains locked. Clinical documentation remains read-only, while attachment-related changes can be finalized independently.
Common examples include:
- Uploading hospital face sheets
- Adding insurance documentation
- Attaching billing paperwork
- Replacing unreadable scanned documents
- Correcting attachment names or categories
Required Permissions
Users must be granted the appropriate role-based permissions to manage attachments on locked incidents.
Required permissions may include:
- View Attachments
- Create Attachments
- Update Attachment Metadata
- Delete Attachments
- Finalize Attachment Updates
Permission availability is determined by your agency's security configuration.
Typical users include:
- Billing Staff
- QA/QI Reviewers
- Supervisors
- Administrators
Provider access is optional and configurable by the agency.
Video
Step-by-Step Guide
Step 1: Open a Completed ePCR
- Navigate to Incident Documentation.
- Locate and open a completed (locked) ePCR.
- Notice that all clinical documentation remains read-only.
The Attachments section remains available if you have the required permissions.
Step 2: Manage Attachments
Within the Attachments section you may:
- Add a new attachment
- View an existing attachment
- Rename or reclassify an attachment
- Delete an attachment
These actions do not unlock the incident or change its completion status.
Step 3: Review Attachment Changes
Once an attachment has been:
- Added
- Updated
- Deleted
The system marks the incident as having pending attachment changes.
If you have permission, the Finalize Attachment Updates button becomes available in the page header.
Step 4: Finalize Attachment Updates
After completing all attachment changes:
- Select Finalize Attachment Updates.
- Review the confirmation message.
- Click Finalize to finalize your changes.
The system will:
- Clear the pending attachment status
- Record the action in the audit history
- Evaluate whether previously exported endpoints should receive updated attachment information
When complete, a confirmation message appears:
How Export Processing Works
Finalizing attachment updates does not automatically resend records to every endpoint.
Instead, First Due evaluates previously exported endpoints and follows each endpoint's export rules.
The system:
- Evaluates only endpoints that previously received the incident
- Honors each endpoint's Export Once setting
- Does not create new exports for endpoints that never received the incident
This ensures attachment updates follow existing integration rules while preventing duplicate exports.
Compliance & Security
To preserve the legal integrity of completed patient care records:
- Clinical documentation remains locked.
- Structured incident fields cannot be edited.
- Demographic information cannot be modified.
- AI extraction into incident fields is disabled.
- Attachment activity is fully audited.
- All changes include the user, timestamp, and action performed.
This design supports operational workflows while maintaining documentation integrity.
Best Practices
- Upload all supplemental documentation as soon as it becomes available.
- Verify attachment names and categories before finalizing.
- Complete all attachment changes before selecting Finalize Attachment Updates.
- Limit attachment management permissions to appropriate administrative roles.
- Review audit history when verifying post-completion changes.
Avoid:
- Attempting to modify clinical documentation after completion.
- Finalizing multiple times unnecessarily.
- Assuming every finalized attachment will be resent to external systems.
Troubleshooting & FAQs
Why can't I edit the patient's documentation?
Completed incidents remain locked to preserve clinical documentation. Only attachment management is available.
Why don't I see the Finalize Attachment Updates button?
The button only appears when:
- You have the required permission.
- An attachment has been added, updated, or deleted.
- The incident is already completed.
I finalized my attachment updates, but nothing was exported.
If the incident has never been exported, no export occurs.
If an endpoint is configured with Export Once, the attachment update is not resent after the original export.
Can I upload hospital face sheets after the report has been completed?
Yes. This feature is specifically designed to support post-completion documentation such as hospital face sheets, billing paperwork, and other supplemental attachments.
Does adding an attachment reopen the incident?
No. The incident remains completed and locked throughout the attachment management process.
Use Case Example
A completed ePCR has already been submitted to QA. The following morning, hospital staff provide the patient face sheet.
A billing specialist:
- Opens the completed ePCR.
- Uploads the face sheet.
- Reviews the attachment.
- Selects Finalize Attachment Updates.
The incident remains locked, the attachment is recorded in the audit history, and First Due evaluates whether previously exported billing endpoints should receive the updated attachment based on their configured export rules.